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Aetna Medicare Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in SW MO / SE KS Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Signature (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Aetna Medicare Signature (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4200.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Aetna Medicare Signature (HMO-POS) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when filling your prescriptions through a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order service, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications, costs are based on coinsurance rather than set copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These coinsurance rates remain the same whether you use preferred or standard pharmacies and mail-order services.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage featuring no copay and no coinsurance for primary care doctor visits, annual physicals, and home health services. For specialist visits and emergency care, members will pay flat copayments, such as a $45 copay for specialists and a $150 copay for emergency room visits, with no coinsurance. Inpatient hospital stays require a $415 daily copay for the first six days, followed by no copay for days seven through ninety. Routine vision and hearing exams are covered with no copay, and the plan provides annual allowances of up to $100 for eyewear and $500 per ear for prescription hearing aids. Preventive dental services also feature no copay, while comprehensive dental care is covered with a 20% to 50% coinsurance up to a $750 annual limit. Additionally, durable medical equipment and diabetic supplies are available with no copay and a coinsurance ranging from 0% to 20%.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $415 daily copay for days 1 to 6 and no copay for days 7 to 90. Although unlimited additional acute hospital days are covered with no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by Aetna Medicare Signature (HMO-POS) feature no coinsurance, with copays ranging from no copay for ambulatory surgical center and blood services to $45 for substance abuse sessions, up to $375 for outpatient hospital services and $415 per stay for observation services. Prior authorization is required for outpatient hospital, observation, ambulatory surgical, and substance abuse services.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization benefits with no coinsurance, although prior authorization is required. Depending on the service, you will pay a copayment of either $55.00 or $180.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ambulance services with prior authorization, requiring a $295 copay and no coinsurance for ground transportation, and a 20% coinsurance with no copay for air transportation. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by the Aetna Medicare Signature (HMO-POS) plan with a $150 copay—waived if admitted to the hospital within 24 hours—and no coinsurance. Urgently needed services require a $45 copay with no coinsurance, while worldwide emergency and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $150 to $295.
Primary Care See details
Primary care benefits offered by Aetna Medicare Signature (HMO-POS) feature no copay and no coinsurance for primary care physician visits, while specialist, therapy, and mental health services require a copay of up to $45 and no coinsurance. Additional telehealth services are covered with a $0 to $45 copay and 20% coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance for annual physicals, fitness benefits, and various screenings, while kidney disease education requires no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), offering Medicare-covered exams for a $45 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no copay and no coinsurance for eye exams and eyewear. This benefit includes one routine eye exam per year and a combined maximum coverage of $100 annually for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services covered by Aetna Medicare Signature (HMO-POS) include Medicare-covered dental with a $45 copay and no coinsurance, alongside preventive care with no copay and no coinsurance. Comprehensive services are partially covered with no copay and 20% to 50% coinsurance up to a $750 annual limit, though fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay and require prior authorization. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (HMO-POS) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and prior authorization required. Coinsurance ranges from 0% to 20% for most items, though a flat 20% coinsurance applies to prosthetic devices and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic services with no coinsurance, featuring no copay for lab services and a $0 to $45 copay for diagnostic procedures. Radiological services are also covered with prior authorization, featuring no copay for diagnostic radiology, no copay but applicable coinsurance for X-rays, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under Aetna Medicare Signature (HMO-POS); although the plan notes some services are covered with no coinsurance, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and carry a $5 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and although a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO-POS), including acupuncture for a $20 copay and no coinsurance up to 12 treatments per year, plus annual wellness exams and select screenings with no copay and no coinsurance. Over-the-counter (OTC) items, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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